For a couple trying to conceive, a diagnosis like azoospermia (no sperm in ejaculate) or oligospermia (low concentration of sperm in ejaculate) can be very devastating. Fortunately, there are technologies available to help retrieve sperm to be used in an in vitro fertilization (IVF) cycle with intracytoplasmic sperm injection (ICSI).
Medical Director of Advanced Fertility Services in New York City says procedures like Microsurgical Epididymal Sperm Aspiration (MESA), Percutaneous Epididymal Sperm Aspiration (PESA), and Testicular Sperm Aspiration (TESA) allow urologists and fertility doctors to work together to obtain even a small amount of sperm from testicular or epididymal tissue. "These procedures are ideal for men who have no sperm production in the testes, who have a blockage where sperm can not get out to mix with seminal fluid, for men with a congenital absence of the vas deferens or infection, or those who have had a vasectomy but decide they would like to have a child."
PESA - In PESA, a butterfly needle is inserted into the epididymis to aspirate sperm under local anesthesia. Vasectomy patients are the strongest candidates for PESA.
MESA - MESA involves sperm aspiration through a small gage needle inserted into the epidydmis via the scrotum under local anesthesia. Urologists examine any fluid obtained through MESA to extract live, moving sperm. Men with little or no sperm in their ejaculate are candidates for MESA.
TESA - TESA is an open surgery under general anesthesia which requires a urologist to remove testicular tissue believed to contain pockets of sperm. Men with little or no sperm in their ejaculate are candidates for TESA. Because TESA is a more invasive procedure, there is a longer recovery time and greater expense.